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Pharmacists, Members of Congress Offer Support for Proposed Improvements to Medicare Part D

One hundred fifty-one (151) organizations, including the National Community Pharmacists Association (NCPA) and the National Rural Health Association, sent a letter today to Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner in strong support of a number of provisions included in the agency’s proposed regulation for 2015 Medicare Part D prescription drug plans. The letter comes as more Members of Congress contact CMS in support of its proposal to expand beneficiary choice by allowing independent community pharmacies the opportunity to participate as “preferred” providers if they are willing to accept the contract offered by a drug plan.

“We want to take this opportunity to voice our strong support for certain proposed changes to the Medicare Part D prescription drug program that will allow more meaningful beneficiary choice and increased marketplace competition,” the organizations wrote in the letter on behalf of pharmacy providers and drug supply chain participants from across the country.

Highlights from the letter include the following:

To increase beneficiary choice and enhance market competition, the groups noted that “We support CMS’ proposal to require Part D plan sponsors to offer terms & conditions for every level of cost sharing, including preferred cost sharing, to any willing pharmacy that will accept the terms.” They also noted that “although the agency was led to believe that its costs via preferred pharmacy networks to be uniformly lower, CMS’ own findings proved otherwise.”

Full support of CMS’ proposal to expand access to critical medication therapy management (MTM) services, which are “ideally provided face-to-face by a pharmacist” and “must become a cornerstone of the Prescription Drug Benefit.”

“We support CMS’ expectations that pharmacies should have current data on the amount of reimbursement they can expect, which in turn impacts costs that plan sponsors submit to CMS as well as prices displayed on Plan Finder.”

The coalition letter comes in conjunction with a series of Congressional letters to CMS in support of the pharmacy choice and competition (or “any willing provider”) provisions within the proposed rule.

U.S. Sen. Roger Wicker (R-Miss.) wrote to CMS that, “I have heard from many Medicare recipients who now have to travel to neighboring towns or counties to find new and larger preferred network pharmacies. For many patients, the cost and physical strain associated with unnecessary travel may keep them at home. Last month, CMS released its proposed rule for Medicare Part D, and I was encouraged to see language that addresses the unintended problems that have developed with these preferred networks. I thank you for your attention to this issue affecting America’s community pharmacists and Medicare patients.”

In addition, U.S. Rep. Doug Collins (R-Ga.) recently wrote to CMS to follow up on a March 2013 letter he and 30 other Members of Congress sent the agency. This week he wrote that, “independent and community pharmacists have dedicated their careers to providing quality patient care, but exclusion from preferred networks has resulted in a strain on their patients and their businesses. I was pleased to see that your agency’s proposed rule on Part D included promising language that addresses some of the concerns laid out” in the March 2013 letter.

Earlier this year, U.S. Reps. Mike Rogers (R-Ala.) and Lynn Westmoreland (R-Ga.) sent their own letters to CMS in support of the any willing provider provision.

The National Community Pharmacists Association (NCPA®) represents the interests of America’s community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent an $88.7 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists. To learn more, go to www.ncpanet.org, visit facebook.com/commpharmacy, or follow NCPA on Twitter @Commpharmacy.